Posted by BBob on June 14, 2000, at 22:36:20
In reply to Re: lithium vs. placebo - An opinion, posted by SLS on June 14, 2000, at 11:02:29
> 1. Both lithium and Depakote (valproate) are substantially better than placebo in treating bipolar disorder.Unsubstantiated declarative statement, the logical foundation of which is based on the presumed authoritI of the speaker.
> 2. Both lithium and Depakote work in the short-term and the long-term. (Depakote may work a bit more quickly in some cases)IBID
> 3. People have been kept well on lithium for DECADES.
IBID
> 4. Many people who have been kept well by lithium for years relapse within 4 months once they discontinued taking it.
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> - Many of these people respond again to lithium when it is restarted.
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> - Some of these people never again respond to lithium, regardless of how many times it is restarted, and regardless of how high the dosage is increased.
Niether "many" nor "some" are relational to a specific quantity, apparently reverting to previous unsubstantiated argument of authority> 5. No single antidepressant works for everyone. Mood stabilizers are no different in this regard.
"Works" "everyone" and other terms undefined. Ignore statement.
> Just because some very important researchers take part in a study, this does not guarantee its reliability. If the design of a study were flawed, even Einstein wouldn't come up with the right results.Growing evidence of need to rebut findings. What is the writer defending? A popular drug?
> > In the only long-term placebo-controlled study in 25 years of a medication used to treat clients diagnosed as bipolar, psychiatrist Charles L. Bowden of the University of Texas Health Science Center found that both lithium chloride and valproate performed about as well as a placebo in long-term treatment of bipolar symptoms, Science News reported in a May 27 edition. The Dr. Bowden's study was also summarized in the May Archives of General Psychiatry.
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> Study URL:
> http://archpsyc.ama-assn.org/issues/v57n5/full/yoa8223.html
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> I thought it was important to try to rip this study to shreds. I'm not sure I can. However, my conscience urges me to post on this board some evidence that lithium is an effective drug. I don't think it is in the best interests of people reading this thread to assume that the results of this study are accurate. There are some pretty big names associated with this article. However, the authors are bound by a scientific ethic to draw their conclusions based upon the results produced by their study design.
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> It is commendable that the investigators had the courage to submit this article, despite its obviously flawed outcome.
Obvious? Kindly submit evidence, please, refering to sources other than personal authority.
Decades of clinical experience demonstrate that lithium is indeed superior to placebo in the treatment of bipolar disorder. I had a conversation with a scientist over the weekend about this article and its inferences. He thought it likely that it was a "failed" study, and that it shows some potential problems in its designs and results. But that is opinion.Indeed. Opinions previal.
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> Now, having said this, let me describe why reboxetine, an antidepressant, has not been approved by the FDA for sale in the United States. One of the studies that the FDA was depending on to reach its decision "failed". A study is said to fail when it is determined that the experiment just plain didn't work."Plain"? "Work?" Are these terms defined?
> The results of such a study can not be deemed reliable. Something went wrong.
Something? What? What does the writer mean by wrong? Per chance does that mean does not concur with personal perceptions of personal experience?
> In the investigation comparing reboxetine to Prozac to placebo, neither reboxetine nor Prozac were superior to placebo. This was a failed study. If we were to look only at this one study, Prozac should never be used again because it doesn't work. It does.How does a stude the show Prozack "works" differ from a study that shows Prozak is associated with increased suicidal or violent ideation?
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> There are a bazillion other studies that demonstrate that both lithium and Depakote are superior to placebo - many, many of them conducted by these same researchers, including Dr. Bowden. Long-term? Well, one may want to decide for themselves as to the relevance of the Bowden 12-month study to developing a perspective of the "long-term" efficacy these drugs.
Bazillion is an absurd term. The writer reverts to ridicule. Argument failed.
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> I don't feel like trying to pick the study apart and cite the overwhelming evidence demonstrating that lithium works. So I will try something simpler. (I hope it works)Ridicule is indeed simple.
another writer posted: would not it be intersting if lithium worked because of placebo affect (paraphrase)
Just another opionion, reflecting curiosity rather than conviction.
(boBB is not Todd!!!)
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> Questionaire: Looking for success stories only -
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Oops! experiment design obviously excludes well documented evidence of toxic effect. More positive results of the UT study were excluded because many subjects dropped out after experiencing negative side effects. No similar effects were reported from placebo group.
poster:BBob
thread:36179
URL: http://www.dr-bob.org/babble/20000610/msgs/37330.html